¹Dr. Muhammad Bilal, ²Dr. Zeeshan Ahmad, ³Dr Waqas Ahmed, ⁴Dr. Bakht Umar Khan, ⁵Dr. Saqab Saboor, ⁶Dr. Rizwan Ali

 CORRESPONDING AUTHOR: DR. MOHSIN SAIF
Armed Forces institute of Cardiology, National institute of Heart Diseases, Rawalpindi

¹Armed Forces institute of Cardiology, National institute of Heart Diseases, Rawalpindi

²Armed Forces Institute of Cardiology and National Heart Diseases.

³Fellow Interventional Cardiology, Armed Forces Institute Of Cardiology And National Institute                                                                  Of Heart Diseases, Rawalpindi.

⁴Fellow interventional cardiology, Armed Forces Institute Of Cardiology And National Institute Of Heart Diseases, Rawalpindi.

⁵Frontier Medical and Dental College.

⁶Armed Forces institute of Cardiology, National institute of Heart Diseases, Rawalpindi

ABSTRACT:

Background: Acute Kidney Injury (AKI) was acknowledged as the major and common complication in patients presenting with Acute ST-Elevation Myocardial Infarction (STEMI). Renal impairment of such patients was frequently due to interplay between decreased cardiac output, hypoperfusion of kidneys, exposure to contrast during diagnostic / interventional measures, and overall systemic inflammation. Not only did AKI enhance the cases of short-term morbidity, but it also deteriorated long-term outcomes, such as mortality and readmission rates. Determining the occurrence of AKI and risk factors in STEMI patients was thus essential in the maximization of preventive measures and enhancing the prognosis.

Purpose: The purpose of the study was to find out how often Acute kidney Injury occurs among patients presenting with Acute ST-Elevation Myocardial Infarction in a tertiary cardiac care unit.

Methods: It is an observational, cross-sectional study that was carried out at the Armed Forces Institute of cardiology/National Institute of heart diseases (AFIC/NIHD) between August 2024 and April 2025. The patients who were used were 100 patients diagnosed with Acute STEMI, which was confirmed by ECG and cardiac biomarkers. The patients who had had pre-existing chronic kidney disease, contrast exposure or who were hemodynamically unstable before admission were excluded. The creatinine levels of serum were discovered at the time of admission and 48-72 hours following the intervention. The criteria used to define AKI were based on the kidney disease: Improving Global Outcomes (KDIGO) system, which is the increase of serum creatinine over 0.3 mg/dl within 48 hours or 1.5 times the baseline within 7 days. As such, demographic data, clinical characteristics, and lab findings were documented and statistically analyzed with SPSS version 26.

Results: Of 100 patients, 28 (28) patients developed Acute Kidney Injury in hospital. The average age of the patients was 58.4 years old and was male dominated (72%). In anterior cardiac infarction of the wall, AKI was more common than in inferior cardiac infarction (39.3 vs. 21.4). The development of AKI was significantly related to hypertension (p = 0.03), diabetes mellitus (p = 0.01) and the higher the Killip class on admission, the higher the relationship was (p < 0.01). The baseline mean serum creatinine of 0. 98 due to 0.21 mg/dl was compared with the serum creatinine level after 72 hours post-PCI of 1.46 due 0.34 mg/dl. In AKI, patients experienced a lengthy hospital stay and increased in-hospital complication rates than the non-AKI patients.

Conclusion: The occurrence of the Acute Kidney Injury in patients with the Acute ST-Elevation Myocardial Infarction was significant. Old age, diabetes mellitus, hypertension, and elevated Killip class were identified as significant factors with which advanced age was associated with the occurrence of AKI. Renal protection measures and early identification were necessary to reduce the number of renal complications and enhance clinical outcomes in this high-risk population.

Keywords: Acute Kidney Injury, ST-Elevation Myocardial Infarction, Frequency, Risk Factors, Renal Dysfunction, PCI.